Panuveitis can be one of the most challenging problems in Ophthalmic Surgery as this type of severe and pervasive inflammation can affect multiple aspects of the eye resulting in loss of vision. This particular patient needs the Retisert steroid implant for the treatment of severe inflammatory complications. Alan N. Carlson, M.D., Professor of Ophthalmology and Chief of the Corneal and Refractive Surgery Service at the Duke Eye Center in Durham, NC works closely with Glenn Jaffe, MD and Pratap Challa MD to treat this patient with removal of scar tissue (synechialysis and removal of pupillary membrane), cataract removal, intraocular lens […]

TearScience Inc. announced that it sponsored research for seven scientific posters on evaporative dry eye and its technology at ARVO. Subjects reflect new, ongoing research on the disease, TearScience’s technology, and clinical outcomes. The posters cover topics such as how the LipiFlow Thermal Pulsation System can rejuvenate Meibomian gland secretions for up to a year as well as LipiFlow’s efficacy and safety over warm compress therapy for treating Meibomian gland dysfunction. Another demonstrates LipiView Ocular Surface Interferometer’s ability to consistently and accurately measure the thickness of thin film, optically similar to the tear film. Additional research presented increases the general […]

Combining cataract and glaucoma surgery in a single procedure is not new. Alan N. Carlson, M.D., Professor of Ophthalmology and Chief of the Corneal and Refractive Surgery Service at the Duke Eye Center in Durham, NC has the enormous privilege of working along with one of the top Glaucoma Services in managing patients that have co-existing Glaucoma along with cataracts and corneal problems. A “best practices” approach to patients that simultaneously have visually significant cataracts along with poorly controlled glaucoma is to combine cataract surgery with trabeculectomy. Drs. James Kim and Rand Allingham of the Glaucoma Service at the Duke […]

Alan N. Carlson, M.D., Professor of Ophthalmology and Chief of the Corneal and Refractive Surgery Service at the Duke Eye Center in Durham, NC along with Ophthalmic Technician, Adam Staley explain what it takes to prepare for a Duke Basketball game. Whether playing or watching, in Cameron Indoor Stadium, the key is to be “in the game.” That means full, all-out engagement in the moment. Here is how Adam and Big Al prepare for the big game!

What special or additional considerations are needed when managing the patient with a particularly dense cataract? Alan N. Carlson, M.D., Professor of Ophthalmology and Chief of the Corneal and Refractive Surgery Service at the Duke Eye Center in Durham, NC is frequently asked this question by patients as well as trainees and it begins with the preoperative assessment. A dense lens will require more energy to remove it so making sure the zonular support is adequate and that the corneal endothelial cell density is appropriate as these patients will likely have more corneal edema after surgery requiring a longer period […]

Alan N. Carlson, M.D., Professor of Ophthalmology and Chief of the Corneal and Refractive Surgery Service of the Duke Eye Center was inspired by the “Friends of Fuchs” organization and the feedback from his presentation was overwhelming. In follow up, he shares the following video demonstrating his technique for Corneal Transplantation (using the DSEK, DSAEK technique) combined with cataract surgery and intraocular lens insertion. This particular patient was considering retirement due to her poor vision and also because surgery is a significant part of her occupation. She is now re-thinking that decision as her vision from her first eye is […]

The Duke Eye Center is uncompromising with respect to their commitment to patient care and quality outcomes. One of the most disturbing and sometimes devastating “let downs” that a patient and surgeon can experience after cataract surgery occurs in the patient who has undergone surgery that is perfect from a technical standpoint but in the healing process after surgery a vitreous floater and epimacular membrane develops. While vitreous floaters are transient, an epimacular membrane’s impact can potential more disturbing and permanent. Fortunately, the surgical options to correct this problem have greatly improved over the past several years. To better understand […]

I had a patient referred today who has keratoconus and a cataract and the question about which intraocular lens (IOL) to use came up as a wonderful discussion with the patient as well as my colleagues. While a Toric IOL may sound very appealing in a patient with a large amount of astigmatism, here are the problems:
a) Patients with KC have a dynamic (nonstatic) condition that could not only worsen but progression may include a change in both magnitude and direction of the astigmatism.

b) The astigmatism correctable by a Toric IOL is “regular” (orthogonal) astigmatism and patients with keratoconus have […]